Patient Engagement is a Pointless Pursuit

The internet is littered with examples of groups attempting to empower patients. The patient’s voice needs to be heard, the patient’s rights matter and my all-time favorite, empowering the patient to be an active participant in the care they receive. All true, all worthy aspirations and in 99% of cases, all pointless.

To suggest patients can influence the machine that drives modern healthcare is naïve and indicative of a flawed understanding of the realities of the industry. It is nothing more than pandering to the cash cows of the industry – you and I.

It is not merely the patients who are powerless cogs in the machinations of healthcare. Their care providers suffer a similar fate. Caregivers are not responsible for the systematic erosion of patient centered medicine, they too are victims. Focusing on relationships between provider and patient is therefore a wholly fruitless endeavor.

Systemic remedies are required

As an analogy, consider if you will, the provider and the patient as cellmates in a high security prison constructed and manned by pharma, insurers and their intermediaries. No amount of debate and planning between the two cellmates is going to result in their release or an improvement in their living conditions. Their only hope lies in reprieve and relying on the humanity of their jailers. If it is lacking, the pair are doomed.

Call me cynical (guilty as charged) but I cannot envision a world in which healthcare companies suddenly decide to eschew profitability for the benefit of their customers. If anything, with every passing decade, rampant capitalistic profiteering will likely worsen the lot of patients and providers, as more intermediaries emerge in the ever growing chain of healthcare and market share declines with negative population growth.

In short, our current health system globally, warped over decades from a humanity based, service industry into the profit based system of exploitation we now deal with, is as good as it gets for you and I. It cannot and will not change.

Appeasing the masses

No one likes to feel they are trapped in a system over which they have little or no control. As the healthcare system evolves and refines itself, incremental changes will center care on establishing dependency (treatment, not cure) and further isolating the farmers (providers) and their flocks (you and I) into managed farming units focused on maximizing revenues.

If you’ve seen intensive chicken farming, you get the idea.

All the signs are there and have been for the last two decades, but like all unpleasant realities, we simply turn a blind eye, as we understand on an instinctive level that we are powerless to affect change. And yet, we continue to posture, we continue to whistle into the wind. All to no effect.

While it is true that patient advocacy groups do occasionally secure small victories, these victories inevitably come at a price, usually exacted on services or pricing in a fashion so subtle that the further erosion of control goes unnoticed.

Patient activism is even encouraged by the industry to pacify the masses. The industry will go as far as sponsoring and participating in many of the patient advocacy groups that proliferate the healthcare market. Appearances matter, results however, cost extra and never at the expense of the bottom line or without a quid pro quo.

Escaping Alcatraz

So what choice then, for patient and provider, caught up in the gears of a machine intent on using them for the pursuit of profits? It is too late to walk any of this back and it cannot be undone. We lack the social backbone to address it and those who can address it lack any form of incentive that supersedes profit.

How do we return healthcare to its former heady days of doctors serving their patients, of ethical medicine, of deep bonds of trust and respect between both patient and provider. How do we ensure that future generations can benefit from technology and medical advances to improve their health, rather than being cycled into a chain of dependency, for those fortunate enough to afford anything approximating to care.

If we cannot change the existing system, the unpleasant alternative is to part ways with it. To strike out into the medical wilderness, forgoing healthcare insurers, pharma and the wretched leeches that inhabit the spaces between. To separate, permanently, the ties that bind both patient and provider to flawed systems that perpetuate abhorent levels of care.

I firmly believe this to be our only option if we are to ensure fair and free access to healing for future generations.

How this future would look and what it would encompass for doctors and patients remains to be seen, but the break needs to be made, before the gates shut for good on the flock.